Individual provider Active NPI

Ethan Robert Snowden

  • Physician Assistant
  • Monroe, LA
National Provider Identifier
1902752009
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
350988 Issued in LA
Practice address
1501 Louisville Ave
Monroe, LA 71201-6025
Phone
(318) 323-8451
NPI assigned
Mar 10, 2026
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 350988 LA Primary

Addresses

Primary practice location

1501 Louisville Ave
Monroe, LA 71201-6025

Mailing address

2301 Timberline CT Apt D108
Ruston, LA 71270-5286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331002571 LA Practitioner - Physician Assistant 8123503836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Clinic of MonroeGroup PAC ID 0840252698, 35 clinicians

Practice addresses (Care Compare)

1501 Louisville Ave
Monroe, LA 71201-6025
Phone 31832384514310

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
350988LAMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1902752009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 TIMBERLINE CT APT D108",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 LOUISVILLE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712016025",
            "telephone_number": "318-323-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOWDEN",
        "first_name": "ETHAN",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "350988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.